CHEST Guidelines-Management-of-Lung-Nodules-and-Lung-Cancer-Screeni

Management-of-Lung-Nodules-and-Lung-Cancer-Screeni

Pdf Summary

During the COVID-19 pandemic, managing lung cancer screening and lung nodules presents unique challenges due to the potential exposure risks and resource reallocation toward combating the virus. An expert panel of pulmonologists, thoracic radiologists, and surgeons formulated consensus guidelines to assist clinicians in adapting lung cancer screening and management practices to current pandemic conditions. <br /><br />The panel developed 12 consensus statements addressing various clinical scenarios, including baseline and annual lung cancer screening, surveillance of previously detected lung nodules, evaluation of intermediate and high-risk nodules, and management of clinical stage I non-small cell lung cancer (NSCLC). Key recommendations suggest deferring nonurgent scans and interventions, consistent with CDC guidance, to avoid exposure risk and mitigate strain on healthcare resources. For instance, delaying baseline or repeat annual screenings, along with surveillance imaging for low-malignancy probability nodules, is advised.<br /><br />Evaluation and management strategies for nodules with an intermediate to high probability of cancer (pCA) are modified, suggesting initial non-invasive testing like PET scans over immediate surgical interventions, aligning with resource limitations and minimizing potential COVID-19 exposure. The delay or modification of treatment for diagnosed stage I NSCLC is also considered reasonable, based on cancer characteristics, patient health, and community COVID-19 levels.<br /><br />These statements emphasize the importance of individualized patient care decisions that consider local COVID-19 impact, resources, and patient-specific factors. They serve to provide clinicians with a framework for managing lung cancer screening and treatment during the pandemic, encouraging adaptation to the evolving healthcare landscape while maintaining patient safety.

Keywords

COVID-19 pandemic

lung cancer screening

lung nodules

consensus guidelines

pulmonologists

thoracic radiologists

non-small cell lung cancer

PET scans

patient care

healthcare resources